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PubMed2000

Interceptive orthodontics in the real world of community dentistry.

OBJECTIVE: To test the applicability and effectiveness of interceptive orthodontics in a community field trial. DESIGN: Prospective screening for suitable malocclusions, implementation of treatment and analysis of outcomes 12 months later. SETTING: Community dentistry in urban and rural areas of Northern Ireland, 1996-98. SUBJECTS AND METHODS: The initial sample consisted of 2002 children (1014 boys, 988 girls) who were screened in routine community dental inspections. One thousand and sixty (523 aged 9 years, 537 aged 11 years) were domiciled in the urban area of greater Belfast and 942 (479 aged 9 years, 463 aged 11 years) in the rural area of Enniskillen and Omagh, Co. Tyrone. INTERVENTIONS: Interceptive orthodontic treatment. OUTCOME MEASURES: Dental health component of the Index of Orthodontic Treatment Need (IOTN) and specially devised local indices of treatment outcomes. RESULTS: With the use of an interception gauge, orthodontic screening was included in the community dental inspections without difficulty. Thirty-three per cent of children were in need of interceptive treatment. Only 20% of those in need both attended for recall and underwent treatment. Compliance was better in the rural area but the need, with particular reference to extraction of carious first molars, was greater in the urban area. The numbers of children in IOTN grades 4 and 5 fell from 69% at the beginning of the study to 42% at the end. The outcome judged by local indices was 94% in the range of complete success to minimal improvement with only 2% showing deterioration. CONCLUSIONS: One in three children screened in community dental inspections at age 9 and 11 years would benefit from interceptive orthodontics. Parents and children seem reluctant to accept offers of interceptive orthodontics and to having the treatment carried out. Among those complying fully, the interceptive measures are very successful. Not only does community interceptive orthodontics improve the condition being treated but also reduces the need for further treatment.

Chi-Square Distribution↗
PubMed1993

In my opinion: the specialist in community dentistry or dental public health.

The traditional role of the Principal Dental Officer will disappear under the 1993 health-service reforms. The specialist in Community Dentistry will be required to define need, suggest appropriate solutions from available resources to the need, and to monitor outcome. These recommendations should be based upon local knowledge. In the immediate short term, the design, implementation, and evaluation of pilot projects will be an important role. Most of the functions of the specialist will be required within the Regional Health Authorities, but some Crown Health Enterprises will also require these skills.

Community Dentistry↗
PubMed1994

The dental caries experience of 5-, 12- and 14-year-old children in Great Britain. Surveys coordinated by the British Association for the Study of Community Dentistry in 1991/92, 1992/3 and 1990-91.

A series of caries prevalence surveys across Great Britain has been coordinated by the British Association for the Study of Community Dentistry (BASCD) since 1985/86 with the aim of monitoring caries experience in representative samples of school children aged 5, 12 and 14 years of age. The purpose of this report is to present the findings of the surveys of 14-, 5- and 12-year-old children carried out in 1990/91, 1991/92 and 1992/3 respectively. These point prevalence surveys were conducted at the caries into dentine level of diagnosis using clinical examination only and a standardised, predominantly visual, diagnostic method employed by trained and calibrated teams of examiners from each country/region of Great Britain. For the 14-year-old age group, 114,126 children from 179 health authorities/boards were examined. The weighted mean DMFT for the participating countries and regions was 2.30 (range, 1.42-3.55). At age 5 years, 205,444 children from 184 health authorities/boards were examined. The weighted mean dmft for the participating countries and regions was 1.86 (range, 1.04-2.88). At age 12 years, 151,143 children from 186 health authorities/boards were examined. The weighted mean DMFT for the participating countries and regions was 1.27 (range, 0.84-2.08). A wide geographical variation in the results was evident for all three age groups, demonstrating a consistent north-south pattern, with higher levels towards the north of Britain. Trends in caries experience in permanent teeth indicate that the decline is now much slower for 12-year-old than for 14-year-old children and slower than the rate for 12-year-old children during the previous 4 year interval between examinations. For 5-year-old children, overall, the general decline in caries experience has ceased, while increases in dmft and in proportions with untreated dentinal decay are now seen in most parts of Great Britain. The pattern of restorative care provided has deteriorated with a fall in the care index for 5- and 12-year-old children, this finding may be related to changes in service provision within the UK.

Adolescent↗
PubMed1990

A national calibration exercise for the British Association for the Study of Community Dentistry regional examiners.

Representative examiners from all regions in England and examiners from Wales and Scotland took part in a national calibration exercise conducted in Manchester for The British Association for the Study of Community Dentistry (BASCD). Each dentist examined the same group of thirty-three 5-year-old and thirty 14-year-old children independently, and they were asked to examine the children by the same method as that used within that Region when conducting the annual BASCD surveys. Comparisons of inter-examiner differences revealed that in the examination of 5-year-old children diagnoses were not significantly different for 14 out of the 16 Regional examiners. Differences in the conventions applied in the case of missing teeth and 'arrested caries' were found and are discussed. There were no significant differences in the diagnoses for the DMFT for the 14-year-old children amongst all 16 Regional examiners. The calibration exercise allowed a close examination of the application of the BASCD criteria in the field.

Adolescent↗
PubMed1978

Contract grading in community dentistry.

Dental educators are constantly searching for ways to improve the affective environment within dental education. To enhance dental student independence and motivation while reducing anxiety, the authors implemented a contract grading teaching and evaluation technique within their community dentistry courses. This paper reports on faculty and student experiences with the contract grading system. The findings suggest that style of teaching and evaluation may enhance a more personalized understanding of course material and reduce student anxiety during the learning process.

Community Dentistry↗
PubMed1996

The dental caries experience of 14-year-old children in the United Kingdom. Surveys coordinated by the British Association for the Study of Community Dentistry in 1994/95.

This paper reports the results of standardised clinical survey examinations of 127,481 14-year-old children across the United Kingdom. These 1994/95 coordinated surveys are the latest in a series which seeks to monitor the dental health of children and contribute to assessments of the provision of dental services. The criteria and conventions of the British Association for the Study of Community Dentistry trainers' pack 1992/93 were used. Representative samples were drawn from participating health authorities and boards and caries was diagnosed at the caries into dentine (D3) threshold using a visual method without radiography, fibre-optic transillumination or compressed air. The results demonstrated a wide variation in prevalence across the UK, the mean D3MFT for the former English regions (of the National Health Service) and the other UK 'territories' ranging from 1.2 (South West Thames) to 4.1 (Northern Ireland). The overall mean D3MFT across the UK was 1.93 (D3T = 0.63, MT = 0.15, FT = 1.15). Overall, 57 percent of children had evidence of (dentinal) caries experience (D3MFT > 0), although means ranged from 42 percent (South Wales Thames) to 81 percent (Northern Ireland). The inclusion of data from Northern Ireland for the first time in this series confirms that dental caries prevalence is higher in the province than in other areas of the UK. Trends since the 1990/91 surveys can be assessed for Great Britain. These demonstrate an overall fall in D3MFT of 20 percent since 1990/91 (from 2.30 to 1.85). This is, however, due to the 35 percent reduction in the number of fillings (1.68 to 1.09) which was partially offset by an increase in unrestored dentinal decay of 41 percent (0.44 to 0.62). These findings (taken together with results from regions reporting in 1986/87) demonstrate that although overall improvements have continued in this age group, the rate of improvement has slowed and that changes in the pattern of provision of care for those with disease experience continue to give some cause for concern. On average, across the UK, only 59 percent of the dentinal caries experience identified by survey examinations of permanent teeth was seen as fillings (range 48 to 69 percent).

Adolescent↗
PubMed1999

The dental caries experience of 5-year-old children in the United Kingdom. Surveys co-ordinated by the British Association for the Study of Community Dentistry in 1997/98.

OBJECTIVE: This paper reports the results of standardised clinical caries examinations of 176,781 5-year-old children from across the United Kingdom. These 1997/98 co-ordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards and caries was diagnosed at the caries into dentine threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: The results again demonstrated a wide variation in prevalence across the UK, with mean values for d3mft for the current English regions (of the National Health Service) and the other UK 'territories' ranging from 1.02 in the West Midlands to 2.92 in Northern Ireland. Mean d3mft across the UK was 1.68 (d3t = 1.18, mt = 0.26, ft = 0.23). Overall, 43% of children had evidence of caries experience (d3mft > 0), although the means ranged between 33% (West Midlands) and 63% (Northern Ireland). The distribution of caries was highly skewed. Thus the UK mean caries experience for those with disease was 3.94, as opposed to the overall mean of 1.68. Trends over time demonstrate a modest improvement of 8.7% in overall d3mft for Great Britain since 1995/96, compared to the small improvement seen two years ago and the deterioration seen four years previously. Both dt and mt have fallen while ft remained unchanged. The care index has increased in all but one region/territory (14% in 1997/8, compared to 12% in 1995/6). Regional/country means for 1997/8 ranged from 9-23%. This indicator has not, however, regained the levels seen in the past. CONCLUSION: There has been some improvement in the dental health of 5-year-old children. Overall, the provision of operative care for those with dentinal decay has also improved; however, significant groups remain within the population of 5-year-old children who have dental disease and who are in need of dental care.

Child, Preschool↗